自制凝血酶原冻干粉纱块外敷对经外周静脉穿刺中心静脉置管穿刺口出血的效果研究

External application of Self-made Thrombospondin Freeze-dried Powder Gauze Block for Bleeding at the Puncture Port of Peripherally Inserted Central Catheter

目的:探究自制凝血酶原冻干粉纱块外敷对老年患者经外周静脉穿刺中心静脉置管(PICC)穿刺口出血的临床效果。方法:选取南方医科大学附属广东省人民医院2022年1月—2023年2月收治的94例老年PICC患者,将其随机分为对照组与试验组,各47例。对照组患者术后穿刺口预防出血实施常规干预,试验组采用自制凝血酶原冻干粉纱块外敷。比较两组干预效果。结果:试验组穿刺口渗血发生率较对照组低,穿刺口持续渗血时间较对照组短,置管<1周的置管并发症发生率较对照组低,差异有统计学意义(P<0.05)。两组患者置管1周时凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、纤维蛋白原水平比较,差异无统计学意义(P>0.05)。结论:对老年患者PICC穿刺口出血防护中应用自制凝血酶原冻干粉纱块外敷,可缩短穿刺口持续渗血时间,降低渗血严重程度及置管并发症发生率,对凝血功能无明显影响。

Objective:To investigate the clinical effect of external application of homemade thrombospondin freeze-dried powder gauze on bleeding at the puncture port of Peripherally Inserted Central Catheter(PICC)in elderly patients.Methods:94 cases of elderly PICC patients admitted to Guangdong Provincial People's Hospital affiliated to Southern Medical University from January 2022 to February 2023 were selected for the study and randomly divided into the control group and the experimental group,47 cases each.Conventional interventions were implemented to prevent postoperative bleeding at the puncture port in the control group,and self-made thrombospondin freeze-dried powder gauze blocks were applied externally in the experimental group.intervention effect of the two groups were compared.Results:The incidence of puncture port bleeding in the experimental group was lower than that of the control group,the duration of puncture port bleeding was shorter than that of the control group,and the incidence of complications within 1 week of catheter placement was lower than that of the control group,and the difference was statistically significant(P<0.05).Comparison of prothrombin time,activated partial thromboplastin time,prothrombin time and fibrinogen level after one week in the two groups of patients showed no statistically significant difference(P>0.05).Conclusion:Self-made thrombospondin freeze-dried powder gauze block externally can protect elderly patients from PICC puncture port bleeding,shorten the bleeding duration at the puncture port,and reduce complications of PICC.However,it shows no significant effect on coagulation.